Published
Wondering about the rest of his picture. Was he making urine, did he look dry? did the 1L bolus help anything? The levo could make him irritable and hence the vtac - how were the rest of his 'lytes? Why couldn't they get him off the vent and why was he on it in the first place? Depending on when his blood was drawn in relation to the ectopy, the vtach could have contributed to the high troponin.
MLB55
83 Posts
Long story, semi short. 60 some yr old guy with a hx of cabg x 2 and chole admitted for syncopal episodes at an OSH. Patient was over there for a month runs into aki requiring dialysis and cvvh. Kidneys recover, liver fails - ercp x 2. Pt trached and finally sent to us for further management. Was sedated with Ativan up until 1 day before tx, trached and receiving tpn. Guy has intermittent runs of vtach, send full of labs. Troponin = 6.40, who knows if it was even checked at the OSH. They weren't checking his ammonia levels. Initially on norepinephrine at 10, sicu wants vaso and wean norepinephrine... I leave him w vaso on and Levo at 6. What is the pressor of choice for a troponin and guy requiring pressors for maps > 60???